Long-term Outcome of Patients With Persistent Pain Following RCT: National-Dental-PBRN

Objectives: Root canal treatment (RCT) is commonly performed dental surgery with ∼10% of patients reporting persistent pain 6 months after treatment. Little is known about the long-term pain-related outcome of these patients or the additional care they receive.
Methods: Fourty-five patients previously found to have persistent pain 6 months following RCT from the Midwest and South Atlantic regions of the National Dental Practice-Based Research Network were approached for a 3-year follow-up. Frequency of self-reported pain (defined as ≥1 day of pain and average pain intensity of at least 1 out of 10 during the preceeding month), impact pain had on the ability to carry out daily activities, and associated additional health care was measured.
Results: Twenty-seven (60%) patients provided follow-up data at 3.4 years (range: 3.1-3.9). Five (19%) patients met the criteria for pain with their pain being moderate in intensity and present for an average of 6 days (range: 2-20) in the preceding month. One patient was kept from usual activities for 1 day due to pain, which very minimally interfered with the ability to work. Overall, 8 (30%) patients continued to seek care since the 6-month follow-up, accounting for 14 additional dental visits and 3 appointments with a medical doctor. Of the 22 patients not reporting pain, 6 (27%) had 3 medical and 8 dental appointments including 2 additional RCTs, 1 crown replacement, and 1 tooth extraction. Of the 5 patients meeting pain criteria, 2 (40%) had 6 dental appointments including receiving additional RCTs.
Conclusions: Our findings suggest that most patients with persistent pain 6 months after RCT report no pain 3 years after RCT, with about 1 in 5 patients still having pain at 3 years. Nonetheless, persistent pain 6 months after RCT resulted in great amounts of additional dental care.